Incidental finding of anti-mitochondrial antibody: A neglected entity needing reappraisal

Anti-mitochondrial antibody (AMA) is the most specific autoantibody in human pathology, occurring in up to 95% of patients with primary biliary cholangitis (PBC) [ [1] Colapietro F. Lleo A. Generali E. Antimitochondrial antibodies: from bench to bedside. Clin Rev Allergy Immunol. 2022; 63: 166-177 Crossref PubMed Scopus (16) Google Scholar ]. Therefore, the detection of positive AMA in association with elevated alkaline phosphatase fulfills the diagnosis of PBC by current guidelines [ [2] Hirschfield G.M. Beuers U. Corpechot C. et al. EASL Clinical Practice Guidelines: the diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017; 67: 145-172 Abstract Full Text Full Text PDF PubMed Scopus (734) Google Scholar ]. In addition, evidence exists that positive AMA similarly indicates the presence of PBC in patients with elevated GGT and or AST/ALT [ [3] Younossi Z.M. Bernstein D. Shiffman M.L. et al. Diagnosis and management of primary biliary cholangitis. Am J Gastroenterol. 2019; 114: 48-63 Crossref PubMed Scopus (65) Google Scholar ].